Volume 20,
Issue 3,
1971

In a geographically defined population of 1,629 women between the ages of 15 and 60 years, tetanus of the newborn was determined retrospectively to have caused the death of 1,143 of their 7,248 live-born children. Analyzing the data by age cohorts of mothers, we showed that, whereas losing a child due to tetanus was relatively infrequent among the younger mothers, over half the older mothers had endured this experience. When the data were analyzed according to birth cohorts of children, they showed the frequency of death due to tetanus of the newborn to have diminished over a 30-year period from 25% of live births to 0% of live births. Declines in frequency could be directly related to a succession of preventive programs. A program that immunized all women with tetanus toxoid, whether or not they were pregnant, provided the means of eliminating tetanus of the newborn as a public health problem.

In the Karimui in New Guinea, all leprosy patients are being treated with the repository sulfone 4,4′-diacetyldiaminodiphenylsulfone (DADDS). We report the clinical condition and the bacteriological results of the first 750 days of treatment in 28 patients who had sufficient numbers of leprosy bacilli in their skin smears for appraisal of the solid ratio (proportion of solidly staining bacilli) during treatment. The solidly staining bacilli are thought to represent the viable bacilli. Before treatment not all patients had significantly elevated solid ratios, but, in all those that did, the solid ratios decreased to near baseline level in 150 days. No significant increases were seen at 150 days or later; some low, sporadic increases were observed, but these did not appear to represent increases in viable bacilli. The bacterial index (a measure of the number of bacilli) decreased in 750 days an average of 2.20, which corresponds to a loss of 160-fold in numbers of bacilli. Decreases in bacterial index averaged somewhat less in patients whose original bacterial index was 4.0 or greater. No significant increases in bacterial indices were observed.

In an epidemic of viral hepatitis caused by polluted water, 97 of 981 persons examined showed evidence of hepatitis. None of these 97 persons gave evidence of infection with Australia/SH antigen. In 26 persons randomly selected from those with hepatitis, immunoglobulin (IgG and IgM) levels were significantly elevated. We concluded that the causative agent of this short-incubation period hepatitis, which resembled infectious hepatitis, was antigenically different from Australia/SH antigen.

Industry and Tropical Health, VII, Proceedings of the Seventh Conference, Industrial Council for Tropical Health, October 28–30, 1969, Boston. 196 pages, illustrated. Published for the Industrial Council for Tropical Health by the Harvard School of Public Health, 55 Shattuck Street, Boston, Massachusetts 02115. 1970. $10.00.

Dr. Jelliffe has gathered an impressive group of authors for this second edition of Diseases of Children in the Tropics and Subtropics, many of whom are world-recognized authorities in their field. (The reader regrets the unfortunate impression that tropical disease expertise in the United States is limited to New Orleans.) As with most books with multiple authors, there is considerable variation in the quality of writing. One would have wished also for more rigid editing to eliminate unnecessary repetition, particularly in the section on child health services. Nevertheless, the book is generally remarkably well written, concise and current. Illustrations and indexing are excellent. I particularly admired the chapters by Jelliffe, especially the opening chapter which is a fascinating introduction to medical anthropology, the chapter by Bruce-Chwatt on the pediatric aspects of malaria, and the chapter on nutritional disturbances by multiple authors. This book is highly recommended to anyone treating children

Information concerning health problems in most developing nations is often limited to reviews of the country's yearly statistical reports or to restricted intelligence summaries compiled by various governmental agencies. In the instance of former non-English speaking European colonies, access to available data is difficult and information is often in another language. The Republic of Chad, in central Africa, is but one example of an African nation about which we in this country have almost no information concerning health problems. In this monograph, on the second of five proposed countries selected for comprehensive epidemiological studies by the Geographic Epidemiology Unit of The Johns Hopkins School of Hygiene and Public Health (the first having been Perú), Dr. Buck and his colleagues have compiled a comprehensive picture of the diseases endemic to Chad. The investigating field team represented various medical and para-medical disciplines, ranging from a physician-epidemiologist to a social anthropologist, and the latest available scientific field equipment was utilized to collect specimens, with most of the sophisticated laboratory analyses being accomplished in Baltimore.

Of the existing textbooks, none has the unique characteristics of this manual. It has been carefully planned to have breadth, yet brevity, in scope and treatment. Despite the large number of contributors, most of whom are leaders in the field, the format of each chapter is fairly uniform, albeit that some variation was obviously necessary for certain material.

The introductory section gets right down to the business of describing the ways and means of identifying disease producing organisms. This is followed by sections on the identification of bacteria, fungi, parasites, viruses and rickettsia. There are also concise but ample chapters on antimicrobial agents, serodiagnosis, miscellaneous procedures and finally a section on media, reagents, and stains. Throughout, salient facts are well interspersed with informative tables and illustrations. All of these features make this book a useful and vital source of ready and authorative information.

The first edition of this volume was published in 1963. Since then, it has become a standard authoritative text in medical mycology. This reception is well deserved. The book is comprehensive, providing a good overview of the field; it is well illustrated and very well written.

Since its initial publication, there have been many advances in the field of medical mycology. These new developments have made necessary a second edition of the book. In their attempt to bring this work up to date, the authors have extensively revised and enlarged the first four chapters dealing with general aspects of medical mycology. These chapters are entitled: 1 Role of Fungi in the Economy of Nature, 2 Characterization of the Fungi and Actinomycetes, 3 Relation of Medical Mycology to General Mycology, and 4 Medical Mycology. Other chapters have similarly been revised. In addition, the second edition has been expanded to include new chapters on Phaeosporotrichosis, Mycotic Keratitis, and the algal disease, Protothecosis.

In 1945 the book Trichinosis by Dr. S. E. Gould was published with the expressed purpose of bringing “the more important aspects of this disease to the attention of workers in the field of medicine and possibly also to the attention of producers of pork.” The ultimate aims were to assist the physician and his technicians in the detection of the disease and to control and prevent new infections. Dr. Gould believed that trichinosis, which was all too prevalent and too often fatal, could be controlled and possibly eradicated in the United States.

A review of Dr. Gould's second book, Trichinosis in Man and Animals, shows clearly that the above aims have not been met entirely. Although important advances in control have been made in certain geographic areas, it is evident that little progress has been made in the rapid detection of the disease in man by serological or other means.